LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

Aug-14

Stok Peneri Perse Pema Sisa

NO Nama Obat
Awal maan diaan kaian Stok
1 Abbocath No. 22 35 50 85 42 43
2 Abbocath No. 24 13 15 28 3 25
3 Acyclovir Cream 2 0 2 1 1
4 Acyclovir Tab 11 0 11 11 0
5 Alopurinol Tab 100 Mg 37 0 37 10 27
6 Ambroksol 30 Mg 0 0 0 0 0
7 Ambroxol Sirup 0 0 0 0 0
8 Aminofilin 200 Mg 240 0 240 6 234
9 Aminofilin Inj 24mg/Ml 18 0 18 5 13
10 Amoksisilin 500 Mg 287 200 487 239 248
11 Amoksisilin Syr. 125 Mg/5ml 3 10 13 3 10
12 Ampisilin Inj 0 0 0 0 0
13 Antalgin Tab 500 Mg 78 0 78 73 5
14 Antasida Doen Tab Kombinasi 257 200 457 150 307
15 Antasida Syr 1 10 11 8 3
16 Asam Mefenamat 500 Mg 304 0 304 118 186
17 Asam Traneksamat Tablet 30 0 30 0 30
18 Betametason Salep Kulit 5 3 8 1 7
19 Bioneuron Inj 0 0 0 0 0
20 Bioplacenton 0 0 0 0 0
21 Bromhexin Tab 0 0 0 0 0
22 Caviplex Syrup 0 10 10 0 10
23 Cefadroksil 500 Mg 0 0 0 0 0
24 Ciprofloksasin 500 Mg 166 0 166 68 98
25 DIAZEPAM SUPP 2 0 2 0 2
26 Deksametason Inj 5 Mg/Ml-1 Ml 26 0 26 12 14
27 Deksametason Tab 0,5 Mg 335 0 335 118 217
28 Dekstrometorfan Syr 10mg/5ml 3 0 3 0 3
29 Dekstrometorfan Tab 15 Mg 42 0 42 3 39
30 Diazepam Inj 5mg/Ml - 2 Ml 30 0 30 0 30
31 Diazepam Tab 2 Mg 19 0 19 8 11
32 Difenhidramin Hcl Inj 10mg/Ml-1ml 0 0 0 0 0
33 Digoksin Tab 0,25 Mg 18 0 18 3 15
34 Domperidon Syr 2 0 2 0 2
35 Domperidon/Vometa 0 0 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 0 0 0 0 0
38 Eritromisin 250 Mg 0 0 0 0 0
39 Eritromisin 500 Mg 0 0 0 0 0
40 Etanol 70% 0 0 0 0 0
41 Ethyl Klorida (Kloretil) 0 0 0 0 0
42 Famotidin 20 Mg 123 400 523 229 294
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30 0 30
44 Fenobarbital Tab 30 Mg 0 0 0 0 0
45 Ferrolat 54 0 54 0 54
46 Fitodiar 0 0 0 0 0
47 Furosemid Tab 40 Mg 28 0 28 20 8
48 Gentamicin Inj 0 0 0 0 0
49 Gentamicin Salep Kulit 0 0 0 0 0
50 Gentian Violet Larutan 1% 0 0 0 0 0
51 Glibenklamid Tab 5 Mg 60 0 60 0 60
52 Gliseril Guaiakolat Tab 100 Mg 259 0 259 217 42
53 Glukosa Larutan Infus 5% 65 100 165 69 96
54 Grisiovulvin 0 0 0 0 0
55 Haemorogard 0 0 0 0 0
56 Hemorogard / Nuwasir 10 0 10 0 10
57 Hepagard 0 0 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 39 0 39 0 39
59 Hidrokortison Krim 2,5% 1 0 1 0 1
60 Hyoscine Butylbromide 31 100 131 81 50
 Stok Peneri Perse Pema Sisa
NO Nama Obat
Awal maan diaan kaian Stok
61 Ibuprofen Tab 200 Mg 14 0 14 0 14
62 Infus Set Anak 29 0 29 2 27
63 Infus Set Dewasa 34 50 84 43 41
64 Isosorbid Dinitrat Tab Sublingual 47 0 47 6 41
65 Jarum 0 0 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 14 0 0 0 0 0
67 Kalsium Laktas Tab 500 Mg 51 0 51 0 51
68 Kaptopril 12,5 Mg 317 0 317 167 150
69 Kaptopril 25 Mg 0 0 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3cm 0 0 0 0 0
72 Keji Beling 70 0 70 0 70
73 Klonidin 40 0 40 0 40
74 Kloramfenikol Inj 5 80 85 45 40
75 Kloramfenikol Kapsul 250 Mg 0 600 600 352 248
76 Kloramfenikol Salep Mata 1% 0 0 0 0 0
77 Kloramfenikol Syr 0 10 10 3 7
78 Kloramfenikol Tetes Mata 0,5% 0 0 0 0 0
79 Kloramfenikol Tetes Telinga 1% 2 0 2 1 1
80 Klorfeniramin Maleat Tab 4 Mg 0 200 200 95 105
81 Kotrimoksazol Suspensi 240 Mg/5 Ml 7 0 7 2 5
82 Kotrimoksazol Tab 480 Mg 227 100 327 64 263
83 Laxamex 0 0 0 0 0
84 Levertran 0 0 0 0 0
85 Librozim 30 Mg (Enzimfort) 0 0 0 0 0
86 Lidokain Inj 0 0 0 0 0
87 Loperamid 65 0 65 0 65
88 Loratadin 224 0 224 27 197
89 Magasida Tablet Kunyah 0 0 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 57 90 147 91 56
91 Metformin 500 Mg 53 0 53 0 53
92 Metoklopramid 10 Mg 138 0 138 79 59
93 Metoklopramid Inj 24 0 24 7 17
94 Metronidazol Tab 250 Mg 183 0 183 0 183
95 Metronidazol Tab 500 Mg 0 0 0 0 0
96 Mikonazol Salep 4 0 4 0 4
97 Natrium Diklofenak 50 Mg 55 0 55 19 36
98 Neo Diaform 0 0 0 0 0
99 Neurobion 5000 Inj 53 0 53 19 34
100 Neurodex 0 0 0 0 0
101 Nicholin Inj 0 0 0 0 0
102 Nifedipin 10 Mg 16 0 16 0 90
103 Obat Batuk Hitam (Obh) Cairan 7 0 7 2 5
104 Oksitetrasiklin Hcl Salep Kulit 3% 1 0 1 0 1
105 Oksitetrasiklin Hcl Salep Mata 1% 0 0 0 0 0
106 Papaverin Tab 40 Mg 0 0 0 0 0
107 Parasetamol Syr 13 10 23 4 19
108 Parasetamol Tab 500 Mg 322 500 822 490 332
109 Piracetam 400 Mg 40 0 40 24 16
110 Piroksikam 10 Mg 55 0 55 0 55
111 Prednison 5 Mg 60 0 60 5 55
112 Prolipid 0 0 0 0 0
113 Ranitidin Injeksi 74 75 149 100 49
114 Ringer Laktat 62 100 162 129 33
Salbutamol Larutan Respirator Untuk
115 3 0 3 0 3
Nebulizer 2,5 Mg/2,5 Ml Nacl
116 Salbutamol Tablet 2 Mg 48 0 48 48 0
117 Salbutamol Tablet 4 Mg 0 0 0 0 0
118 Salisil Bedak 2% 0 0 0 0 0
119 Simetidin 0 0 0 0 0
120 Simvastatin 59 0 59 0 59
121 Sistabon Inj 0 0 0 0 0
122 Spasmal 0 0 0 0 0
123 Sulfasetamid Na. Tetes Mata 15% 0 0 0 0 0
124 Tensigard 0 0 0 0 0
125 Tramadol 50 Mg 0 0 0 0 0
126 SUFRATULE 5 0 5 1 4
 Stok Peneri Perse Pema Sisa
NO Nama Obat
Awal maan diaan kaian Stok
127 Transamin Inj 0 0 0 0 0
128 Ulcumet 0 0 0 0 0
129 Urispas 0 0 0 0 0
130 Vit. B Kompleks 726 0 726 79 647
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 136 0 136 58 78
132 Vit. B12 Inj 0 0 0 0 0
133 Vit. B12 Tablet 50 Mg 515 0 515 54 461
134 Vit. B6 (Piridoksin Hcl) Tab 10 Mg 378 0 378 115 263
135 Vit. C (Asam Askorbat) Tab 50 Mg 960 0 960 30 930
136 Vit. K1 (Fitomenadion) Inj 10 Mg/Ml-1ml 0 0 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 Mg 146 0 146 14 132
138 Xanvit Sirup 0 0 0 0 0
139 Xylomidon 0 0 0 0 0
140 Zink Dispersibel 0 0 0 0 0
141 Zyparon Kapl 0 0 0 0 0
142 FOLEY KATETER 5
143 SOFRATULLE 3 0 3 0 3
144 Kaotin sy 4 0 4 0 4
145 Imulan 38 0 38 0 38
146 Dimenhidrinate 85 0 85 3 82
147 Cefixim 21 0 21 0 21
148 Omeprazol 0 0 0 0 0
149 antalgin injeksi 27 0 27 21 6

Mengetahui Yang menyerahkan Obat Mengetahui

Kepala Puskesmas kerjo Pengelola Obat Puskesmas Penangung Jawab Rawat

dr.Katarina Iswati Didik Very Ariyanto,Sto,S.Farm.,Apt dr.Siswo Haryon

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013 NIP. 19710810200604
T (LPLPO)

Permin Stok
taan Opname
Permin Stok
taan Opname
 Permin Stok
taan Opname

Mengetahui
Penangung Jawab Rawat Inap

dr.Siswo Haryono
NIP. 197108102006041006
 LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

JUNI 2014

Stok Peneri Perse Pema Sisa

NO Nama Obat
Awal maan diaan kaian Stok
1 Abbocath No. 22 29 70 99 61 38
2 Abbocath No. 24 25 0 25 7 18
3 Acyclovir Cream 3 0 3 0 3
4 Acyclovir Tab 20 0 20 0 20
5 Alopurinol Tab 100 Mg 53 0 53 3 50
6 Ambroksol 30 Mg 4 0 4 0 4
7 Ambroxol Sirup 0 0 0 0 0
8 Aminofilin 200 Mg 258 0 258 4 254
9 Aminofilin Inj 24mg/Ml 22 0 22 3 19
10 Amoksisilin 500 Mg 555 0 555 261 294
11 Amoksisilin Syr. 125 Mg/5ml 15 0 15 6 9
12 Ampisilin Inj 44 0 44 44 0
13 Antalgin Tab 500 Mg 98 0 98 55 43
14 Antasida Doen Tab Kombinasi 357 300 657 387 270
15 Antasida Syr 2 15 17 15 2
16 Asam Mefenamat 500 Mg 630 0 630 116 514
17 Asam Traneksamat Tablet 14 50 64 26 38
18 Betametason Salep Kulit 5 0 5 0 5
19 Bioneuron Inj 0 0 0 0 0
20 Bioplacenton 0 0 0 0 0
21 Bromhexin Tab 85 0 85 0 85
22 Caviplex Syrup 4 0 4 3 1
23 Cefadroksil 500 Mg 29 0 29 26 3
24 Ciprofloksasin 500 Mg 125 0 125 122 3
25 Dasabion 0 0 0 0 0
26 Deksametason Inj 5 Mg/Ml-1 Ml 31 25 56 30 26
27 Deksametason Tab 0,5 Mg 48 200 248 248 0
28 Dekstrometorfan Syr 10mg/5ml 7 0 7 0 7
29 Dekstrometorfan Tab 15 Mg 70 0 70 40 30
30 Diazepam Inj 5mg/Ml - 2 Ml 30 0 30 0 30
31 Diazepam Tab 2 Mg 31 0 31 17 14
32 Difenhidramin Hcl Inj 10mg/Ml-1ml 27 0 27 0 27
33 Digoksin Tab 0,25 Mg 27 0 27 0 27
34 Domperidon Syr 0 5 5 1 4
35 Domperidon/Vometa 0 0 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 2 0 2 0 2
38 Eritromisin 250 Mg 0 0 0 0 0
39 Eritromisin 500 Mg 0 0 0 0 0
40 Etanol 70% 1 0 1 0 1
41 Ethyl Klorida (Kloretil) 0 0 0 0 0
42 Famotidin 20 Mg 40 300 340 269 71
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30 0 30
44 Fenobarbital Tab 30 Mg 193 0 193 0 193
45 Ferrolat 0 60 60 0 60
46 Fitodiar 0 0 0 0 0
47 Furosemid Tab 40 Mg 35 0 35 16 19
48 Gentamicin Inj 0 0 0 0 0
49 Gentamicin Salep Kulit 2 0 2 2 0
50 Gentian Violet Larutan 1% 3 0 3 1 2
51 Glibenklamid Tab 5 Mg 76 0 76 7 69
52 Gliseril Guaiakolat Tab 100 Mg 3 300 303 141 162
53 Glukosa Larutan Infus 5% 110 100 210 108 102
54 Grisiovulvin 0 0 0 0 0
55 Haemorogard 0 0 0 0 0
56 Hemorogard / Nuwasir 36 0 36 12 24
57 Hepagard 0 0 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 7 50 57 6 51
59 Hidrokortison Krim 2,5% 1 0 1 0 1
60 Hyoscine Butylbromide 52 100 152 49 103
 Stok Peneri Perse Pema Sisa
NO Nama Obat
Awal maan diaan kaian Stok
61 Ibuprofen Tab 200 Mg 36 0 36 0 36
62 Infus Set Anak 39 0 39 7 32
63 Infus Set Dewasa 32 75 107 59 48
64 Isosorbid Dinitrat Tab Sublingual 58 0 58 9 49
65 Jarum 0 0 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 14 0 0 0 0 0
67 Kalsium Laktas Tab 500 Mg 62 0 62 0 62
68 Kaptopril 12,5 Mg 132 200 332 242 90
69 Kaptopril 25 Mg 0 0 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3cm 0 0 0 0 0
72 Keji Beling 70 0 70 0 70
73 Klonidin 50 0 50 0 50
74 Kloramfenikol Inj 36 50 86 70 16
75 Kloramfenikol Kapsul 250 Mg 147 480 627 402 225
76 Kloramfenikol Salep Mata 1% 0 0 0 0 0
77 Kloramfenikol Syr 20 0 20 2 18
78 Kloramfenikol Tetes Mata 0,5% 0 0 0 0 0
79 Kloramfenikol Tetes Telinga 1% 4 0 4 0 4
80 Klorfeniramin Maleat Tab 4 Mg 36 100 136 136 0
81 Kotrimoksazol Suspensi 240 Mg/5 Ml 14 0 14 3 11
82 Kotrimoksazol Tab 480 Mg 105 200 305 230 75
83 Laxamex 18 0 18 2 16
84 Levertran 0 0 0 0 0
85 Librozim 30 Mg (Enzimfort) 0 0 0 0 0
86 Lidokain Inj 74 0 74 7 67
87 Loperamid 68 50 118 39 79
88 Loratadin 61 0 61 23 38
89 Magasida Tablet Kunyah 0 0 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 33 120 153 115 38
91 Metformin 500 Mg 65 0 65 4 61
92 Metoklopramid 10 Mg 50 200 250 123 127
93 Metoklopramid Inj 6 30 36 34 2
94 Metronidazol Tab 250 Mg 159 0 159 112 47
95 Metronidazol Tab 500 Mg 0 0 0 0 0
96 Mikonazol Salep 4 0 4 0 4
97 Natrium Diklofenak 50 Mg 72 0 72 3 69
98 Neo Diaform 50 0 50 0 50
99 Neurobion 5000 Inj 104 0 104 18 86
100 Neurodex 0 0 0 0 0
101 Nicholin Inj 0 0 0 0 0
102 Nifedipin 10 Mg 90 0 90 28 90
103 Obat Batuk Hitam (Obh) Cairan 7 8 15 6 9
104 Oksitetrasiklin Hcl Salep Kulit 3% 1 0 1 0 1
105 Oksitetrasiklin Hcl Salep Mata 1% 0 0 0 0 0
106 Papaverin Tab 40 Mg 0 0 0 0 0
107 Parasetamol Syr 4 5 9 6 3
108 Parasetamol Tab 500 Mg 294 1000 1294 855 439
109 Piracetam 400 Mg 117 0 117 18 99
110 Piroksikam 10 Mg 59 0 59 40 19
111 Prednison 5 Mg 0 100 100 21 79
112 Prolipid 0 0 0 0 0
113 Ranitidin Injeksi 14 200 214 176 38
114 Ringer Laktat 42 203 245 243 2
Salbutamol Larutan Respirator Untuk
115
Nebulizer 2,5 Mg/2,5 Ml Nacl
3 0 3 0 3
116 Salbutamol Tablet 2 Mg 46 50 96 58 38
117 Salbutamol Tablet 4 Mg 0 0 0 0 0
118 Salisil Bedak 2% 2 0 2 0 2
119 Simetidin 0 0 0 0 0
120 Simvastatin 59 0 59 0 59
121 Sistabon Inj 0 0 0 0 0
122 Spasmal 0 0 0 0 0
123 Sulfasetamid Na. Tetes Mata 15% 0 2 2 2 0
124 Tensigard 0 0 0 0 0
125 Tramadol 50 Mg 0 0 0 0 0
126 Tramadol Inj 0 0 0 0 0
 Stok Peneri Perse Pema Sisa
NO Nama Obat
Awal maan diaan kaian Stok
127 Transamin Inj 0 0 0 0 0
128 Ulcumet 0 0 0 0 0
129 Urispas 0 0 0 0 0
130 Vit. B Kompleks 550 0 550 151 399
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 73 0 73 62 11
132 Vit. B12 Inj 0 0 0 0 0
133 Vit. B12 Tablet 50 Mg 626 0 626 38 588
134 Vit. B6 (Piridoksin Hcl) Tab 10 Mg 684 0 684 193 491
135 Vit. C (Asam Askorbat) Tab 50 Mg 969 0 969 0 969
136 Vit. K1 (Fitomenadion) Inj 10 Mg/Ml-1ml 0 0 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 Mg 175 0 175 0 175
138 Xanvit Sirup 0 0 0 0 0
139 Xylomidon 0 0 0 0 0
140 Zink Dispersibel 0 0 0 0 0
141 Zyparon Kapl 0 0 0 0 0
142
143 Dulcolax 0 0 0 0 0
144 Kaotin sy 6 0 6 0 6
145 Imulan 38 0 38 0 38
146 Dimenhidrinate 51 0 51 44 7
147 Cefixim 21 0 21 0 21
148 Omeprazol 30 0 30 0 30

Mengetahui Yang menyerahkan Obat Mengetahui

Kepala Puskesmas kerjo Pengelola Obat Puskesmas Penangung Jawab Rawat

dr.Katarina Iswati Didik Very Ariyanto,Sto,S.Farm.,Apt dr.Siswo Haryon

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013 NIP. 19710810200604
T (LPLPO)

Permin Stok
taan Opname
Permin Stok
taan Opname
 Permin Stok
taan Opname

Mengetahui
Penangung Jawab Rawat Inap

dr.Siswo Haryono
NIP. 197108102006041006
 LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

BULAN : FEBRUARI 2014

Stok Peneri Perse Pema

NO Nama Obat
Awal maan diaan kaian
1 Abbocath No. 22 60 50 110 61
2 Abbocath No. 24 29 0 29 4
3 Acyclovir Cream 4 0 4 0
4 Acyclovir Tab 36 0 36 0
5 Alopurinol Tab 100 Mg 58 0 58 0
6 Ambroksol 30 Mg 0 100 100 30
7 Ambroxol Sirup 0 0 0 0
8 Aminofilin 200 Mg 83 0 83 0
9 Aminofilin Inj 24mg/Ml 30 0 30 1
10 Amoksisilin 500 Mg 71 500 571 216
11 Amoksisilin Syr. 125 Mg/5ml 6 0 6 2
12 Ampisilin Inj 0 0 0 0
13 Antalgin Tab 500 Mg 108 0 108 53
14 Antasida Doen Tab Kombinasi 6 500 506 382
15 Antasida Syr 2 6 8 8
16 Asam Mefenamat 500 Mg 208 0 208 51
17 Asam Traneksamat Tablet 58 0 58 24
18 Betametason Salep Kulit 6 0 6 1
19 Bioneuron Inj 0 0 0 0
20 Bioplacenton 0 0 0 0
21 Bromhexin Tab 85 0 85 0
22 Caviplex Syrup 7 0 7 0
23 Cefadroksil 500 Mg 63 100 163 82
24 Ciprofloksasin 500 Mg 133 100 233 100
25 Dasabion 0 0 0 0
26 Deksametason Inj 5 Mg/Ml-1 Ml 67 0 67 14
27 Deksametason Tab 0,5 Mg 1 200 201 175
28 Dekstrometorfan Syr 10mg/5ml 4 0 4 2
29 Dekstrometorfan Tab 15 Mg 148 0 148 26
30 Diazepam Inj 5mg/Ml - 2 Ml 0 0 0 0
31 Diazepam Tab 2 Mg 0 0 0 0
32 Difenhidramin Hcl Inj 10mg/Ml-1ml 27 0 27 0
33 Digoksin Tab 0,25 Mg 7 0 7 0
34 Domperidon Syr 0 0 0 0
35 Domperidon/Vometa 0 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 3 0 3 0
38 Eritromisin 250 Mg 0 0 0 0
39 Eritromisin 500 Mg 0 0 0 0
 40 Etanol 70% 0 0 0 0
41 Ethyl Klorida (Kloretil) 0 0 0 0
42 Famotidin 20 Mg 135 500 635 288
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30 0
44 Fenobarbital Tab 30 Mg 197 0 197 0
45 Ferrolat 0 0 0 0
46 Fitodiar 0 0 0 0
47 Furosemid Tab 40 Mg 0 50 50 35
48 Gentamicin Inj 0 0 0 0
49 Gentamicin Salep Kulit 4 0 4 1
50 Gentian Violet Larutan 1% 1 3 4 0
51 Glibenklamid Tab 5 Mg 91 0 91 0
52 Gliseril Guaiakolat Tab 100 Mg 264 0 264 264
53 Glukosa Larutan Infus 5% 0 100 100 71
54 Grisiovulvin 0 0 0 0
55 Haemorogard 0 0 0 0
56 Hemorogard / Nuwasir 66 0 66 30
57 Hepagard 0 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 18 0 18 0
59 Hidrokortison Krim 2,5% 1 0 1 0
60 Hyoscine Butylbromide 56 100 156 39
Sisa Peneri Perse Pema
NO Nama Obat
Stok maan diaan kaian
61 Ibuprofen Tab 200 Mg 36 0 36 0
62 Infus Set Anak 5 25 30 0
63 Infus Set Dewasa 4 75 79 62
64 Isosorbid Dinitrat Tab Sublingual 10 50 60 2
65 Jarum 0 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 14 0 0 0 0
67 Kalsium Laktas Tab 500 Mg 62 0 62 0
68 Kaptopril 12,5 Mg 371 200 571 360
69 Kaptopril 25 Mg 0 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3cm 0 0 0 0
72 Keji Beling 90 0 90 0
73 Klonidin 100 0 100 0
74 Kloramfenikol Inj 62 50 112 56
75 Kloramfenikol Kapsul 250 Mg 119 900 1019 452
76 Kloramfenikol Salep Mata 1% 0 0 0 0
77 Kloramfenikol Syr 31 0 31 1
78 Kloramfenikol Tetes Mata 0,5% 0 0 0 0
79 Kloramfenikol Tetes Telinga 1% 4 0 4 0
80 Klorfeniramin Maleat Tab 4 Mg 227 0 227 167
81 Kotrimoksazol Suspensi 240 Mg/5 Ml 1 0 1 0
82 Kotrimoksazol Tab 480 Mg 358 100 458 134
 83 Laxamex 0 20 20 0
84 Levertran 0 0 0 0
85 Librozim 30 Mg (Enzimfort) 0 0 0 0
86 Lidokain Inj 41 60 101 0
87 Loperamid 73 0 73 34
88 Loratadin 74 0 74 22
89 Magasida Tablet Kunyah 0 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 12 90 102 100
91 Metformin 500 Mg 40 0 40 0
92 Metoklopramid 10 Mg 100 100 200 145
93 Metoklopramid Inj 24 0 24 6
94 Metronidazol Tab 250 Mg 152 0 152 58
95 Metronidazol Tab 500 Mg 0 0 0 0
96 Mikonazol Salep 3 0 3 1
97 Natrium Diklofenak 50 Mg 106 0 106 16
98 Neo Diaform 0 0 0 0
99 Neurobion 5000 Inj 35 0 35 6
100 Neurodex 0 0 0 0
101 Nicholin Inj 0 0 0 0
102 Nifedipin 10 Mg 0 0 0 29
103 Obat Batuk Hitam (Obh) Cairan 7 6 13 8
104 Oksitetrasiklin Hcl Salep Kulit 3% 1 0 1 0
105 Oksitetrasiklin Hcl Salep Mata 1% 0 0 0 0
106 Papaverin Tab 40 Mg 0 0 0 0
107 Parasetamol Syr 2 0 2 2
108 Parasetamol Tab 500 Mg 18 1000 1018 903
109 Piracetam 400 Mg 169 0 169 28
110 Piroksikam 10 Mg 32 100 132 6
111 Prednison 5 Mg 103 0 103 88
112 Prolipid 0 0 0 0
113 Ranitidin Injeksi 79 75 154 152
114 Ringer Laktat 165 200 365 234
115 Salbutamol Larutan Respirator Untuk Nebul 4 0 4 1
116 Salbutamol Tablet 2 Mg 53 100 153 153
117 Salbutamol Tablet 4 Mg 0 0 0 0
118 Salisil Bedak 2% 0 0 0 0
119 Simetidin 0 0 0 0
120 Simvastatin 67 0 67 0
121 Sistabon Inj 0 0 0 0
122 Spasmal 0 0 0 0
123 Sulfasetamid Na. Tetes Mata 15% 0 0 0 0
124 Tensigard 0 0 0 0
125 Tramadol 50 Mg 0 0 0 0
126 Tramadol Inj 0 0 0 0
 Sisa Peneri Perse Pema
NO Nama Obat
Stok maan diaan kaian
127 Transamin Inj 0 0 0 0
128 Ulcumet 0 0 0 0
129 Urispas 10 0 10 0
130 Vit. B Kompleks 101 0 101 80
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 57 200 257 33
132 Vit. B12 Inj 0 0 0 0
133 Vit. B12 Tablet 50 Mg 720 0 720 12
134 Vit. B6 (Piridoksin Hcl) Tab 10 Mg 14 1000 1014 60
135 Vit. C (Asam Askorbat) Tab 50 Mg 969 0 969 0
136 Vit. K1 (Fitomenadion) Inj 10 Mg/Ml-1ml 0 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 Mg 193 0 193 12
138 Xanvit Sirup 0 0 0 0
139 Xylomidon 0 0 0 0
140 Zink Dispersibel 0 0 0 0
141 Zyparon Kapl 0 0 0 0
142
143 Dulcolax 0 0 0 0
144 Kaotin sy 7 0 7 0
145 Imulan 38 0 38 0
146 Dimenhidrinate 14 50 64 46
147 Cefixim 33 0 33 0
148 Omeprazol 33 0 33 0

Mengetahui Yang menyerahkan Obat

Kepala Puskesmas kerjo Pengelola Obat Puskesmas

dr.Katarina Iswati Hartini

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013
T (LPLPO)

Permin Stok
Sisa Stok
taan Opname
49
25
4
36
58
70
0
83
29
355
4
0
55
124
0
157
34
5
0
0
85
7
81
133
0
53
26
2
122
0
0
27
7
0
0
0
3
0
0
 0
0
347
30
197
0
0
15
0
3
4
91
0
29
0
0
36
0
18
1
117
Permin Stok
Sisa Stok
taan Opname
36
30
17
58
0
0
62
211
0
0
0
90
100
56
567
0
30
0
4
60
1
324
 20
0
0
101
39
52
0
2
40
55
18
94
0
2
90
0
29
0
0
0
5
1
0
0
0
115
141
126
15
0
2
131
3
0
0
0
0
67
0
0
0
0
0
0
 Permin Stok
Sisa Stok
taan Opname
0
0
10
21
224
0
708
954
969
0
181
0
0
0
0

0
7
38
18
33
33

Yang meminta
Petugas Sub Unit

.
NIP.
 LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

Mar-14

Stok Peneri Perse

NO Nama Obat
Awal maan diaan
1 Abbocath No. 22 49 50 99
2 Abbocath No. 24 25 0 25
3 Acyclovir Cream 4 0 4
4 Acyclovir Tab 36 0 36
5 Alopurinol Tab 100 Mg 58 0 58
6 Ambroksol 30 Mg 70 0 70
7 Ambroxol Sirup 0 0 0
8 Aminofilin 200 Mg 83 0 83
9 Aminofilin Inj 24mg/Ml 29 0 29
10 Amoksisilin 500 Mg 355 500 855
11 Amoksisilin Syr. 125 Mg/5ml 4 6 10
12 Ampisilin Inj 0 0 0
13 Antalgin Tab 500 Mg 55 100 155
14 Antasida Doen Tab Kombinasi 124 400 524
15 Antasida Syr 0 40 40
16 Asam Mefenamat 500 Mg 157 1000 1157
17 Asam Traneksamat Tablet 34 0 34
18 Betametason Salep Kulit 5 0 5
19 Bioneuron Inj 0 0 0
20 Bioplacenton 0 0 0
21 Bromhexin Tab 85 0 85
22 Caviplex Syrup 7 0 7
23 Cefadroksil 500 Mg 81 100 181
24 Ciprofloksasin 500 Mg 133 0 133
25 Dasabion 0 0 0
26 Deksametason Inj 5 Mg/Ml-1 Ml 53 0 53
27 Deksametason Tab 0,5 Mg 26 300 326
28 Dekstrometorfan Syr 10mg/5ml 2 6 8
29 Dekstrometorfan Tab 15 Mg 122 100 222
30 Diazepam Inj 5mg/Ml - 2 Ml 0 0 0
31 Diazepam Tab 2 Mg 0 25 25
32 Difenhidramin Hcl Inj 10mg/Ml-1ml 27 0 27
33 Digoksin Tab 0,25 Mg 7 0 7
34 Domperidon Syr 0 0 0
35 Domperidon/Vometa 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 3 0 3
38 Eritromisin 250 Mg 0 0 0
39 Eritromisin 500 Mg 0 0 0
40 Etanol 70% 0 1 1
41 Ethyl Klorida (Kloretil) 0 0 0
42 Famotidin 20 Mg 347 0 347
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30
44 Fenobarbital Tab 30 Mg 197 0 197
45 Ferrolat 0 0 0
46 Fitodiar 0 0 0
47 Furosemid Tab 40 Mg 15 50 65
48 Gentamicin Inj 0 0 0
49 Gentamicin Salep Kulit 3 0 3
50 Gentian Violet Larutan 1% 4 0 4
51 Glibenklamid Tab 5 Mg 91 0 91
52 Gliseril Guaiakolat Tab 100 Mg 0 200 200
53 Glukosa Larutan Infus 5% 29 100 129
54 Grisiovulvin 0 0 0
55 Haemorogard 0 0 0
56 Hemorogard / Nuwasir 36 0 36
57 Hepagard 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 18 0 18
59 Hidrokortison Krim 2,5% 1 0 1
60 Hyoscine Butylbromide 117 0 117
Stok Peneri Perse
NO Nama Obat
awal maan diaan
61 Ibuprofen Tab 200 Mg 36 0 36
62 Infus Set Anak 30 0 30
63 Infus Set Dewasa 17 74 91
64 Isosorbid Dinitrat Tab Sublingual 58 0 58
65 Jarum 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 14 0 0 0
67 Kalsium Laktas Tab 500 Mg 62 0 62
68 Kaptopril 12,5 Mg 211 300 511
69 Kaptopril 25 Mg 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3cm 0 0 0
72 Keji Beling 90 0 90
73 Klonidin 100 0 100
74 Kloramfenikol Inj 56 50 106
75 Kloramfenikol Kapsul 250 Mg 567 1000 1567
76 Kloramfenikol Salep Mata 1% 0 0 0
77 Kloramfenikol Syr 30 0 30
78 Kloramfenikol Tetes Mata 0,5% 0 0 0
79 Kloramfenikol Tetes Telinga 1% 4 0 4
80 Klorfeniramin Maleat Tab 4 Mg 60 0 60
81 Kotrimoksazol Suspensi 240 Mg/5 Ml 1 20 21
82 Kotrimoksazol Tab 480 Mg 324 0 324
83 Laxamex 20 0 20
84 Levertran 0 0 0
85 Librozim 30 Mg (Enzimfort) 0 100 100
86 Lidokain Inj 101 0 101
87 Loperamid 39 50 89
 88 Loratadin 52 0 52
89 Magasida Tablet Kunyah 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 2 120 122
91 Metformin 500 Mg 40 0 40
92 Metoklopramid 10 Mg 55 150 205
93 Metoklopramid Inj 18 10 28
94 Metronidazol Tab 250 Mg 94 100 194
95 Metronidazol Tab 500 Mg 0 0 0
96 Mikonazol Salep 2 3 5
97 Natrium Diklofenak 50 Mg 90 0 90
98 Neo Diaform 0 0 0
99 Neurobion 5000 Inj 29 0 29
100 Neurodex 0 0 0
101 Nicholin Inj 0 0 0
102 Nifedipin 10 Mg 0 100 100
103 Obat Batuk Hitam (Obh) Cairan 5 10 15
104 Oksitetrasiklin Hcl Salep Kulit 3% 1 0 1
105 Oksitetrasiklin Hcl Salep Mata 1% 0 0 0
106 Papaverin Tab 40 Mg 0 0 0
107 Parasetamol Syr 0 20 20
108 Parasetamol Tab 500 Mg 115 1000 1115
109 Piracetam 400 Mg 141 0 141
110 Piroksikam 10 Mg 126 0 126
111 Prednison 5 Mg 15 0 15
112 Prolipid 0 0 0
113 Ranitidin Injeksi 2 200 202
114 Ringer Laktat 131 200 331
115 Salbutamol Larutan Respirator Untuk Nebul 3 0 3
116 Salbutamol Tablet 2 Mg 0 200 200
117 Salbutamol Tablet 4 Mg 0 0 0
118 Salisil Bedak 2% 0 3 3
119 Simetidin 0 0 0
120 Simvastatin 67 0 67
121 Sistabon Inj 0 0 0
122 Spasmal 0 0 0
123 Sulfasetamid Na. Tetes Mata 15% 0 0 0
124 Tensigard 0 0 0
125 Tramadol 50 Mg 0 0 0
126 Tramadol Inj 0 0 0
stok Peneri Perse
NO Nama Obat
awal maan diaan
127 Transamin Inj 0 0 0
128 Ulcumet 0 0 0
129 Urispas 10 0 10
130 Vit. B Kompleks 21 1000 1021
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 224 0 224
132 Vit. B12 Inj 0 0 0
133 Vit. B12 Tablet 50 Mg 708 0 708
134 Vit. B6 (Piridoksin Hcl) Tab 10 Mg 954 0 954
135 Vit. C (Asam Askorbat) Tab 50 Mg 969 0 969
136 Vit. K1 (Fitomenadion) Inj 10 Mg/Ml-1ml 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 Mg 181 0 181
138 Xanvit Sirup 0 0 0
139 Xylomidon 0 0 0
140 Zink Dispersibel 0 0 0
141 Zyparon Kapl 0 0 0
142
143 Dulcolax 0 0 0
144 Kaotin sy 7 0 7
145 Imulan 38 0 38
146 Dimenhidrinate 18 100 118
147 Cefixim 33 0 33
148 Omeprazol 33 0 33

Mengetahui Yang menyerahkan Obat

Kepala Puskesmas kerjo Pengelola Obat Puskesmas

dr.Katarina Iswati Hartini

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013
TAAN OBAT (LPLPO)

Pema Permin Stok

Sisa Stok
kaian taan Opname
68 31
7 18
0 4
0 36
5 53
66 4
0 0
14 69
0 29
430 425
6 4
0 0
18 137
337 187
20 20
247 910
0 34
0 5
0 0
0 0
0 85
0 7
40 141
120 13
0 0
18 35
247 79
0 8
36 186
0 0
0 25
0 27
0 7
0 0
0 0
0 0
1 2
0 0
0 0
0 1
0 0
 346 1
0 30
0 197
0 0
0 0
21 44
0 0
2 1
0 4
0 91
197 3
83 46
0 0
0 0
0 36
0 0
3 15
0 1
76 41
Pema Permin Stok
Sisa Stok
kaian taan Opname
0 36
6 24
69 22
0 58
0 0
0 0
0 62
299 212
0 0
0 0
0 0
0 90
0 100
64 42
604 963
0 0
6 24
0 0
0 4
58 2
1 20
227 97
2 18
0 0
88 12
16 85
21 68
 26 26
0 0
117 5
17 23
162 43
13 15
60 134
0 0
0 5
0 90
0 0
4 25
0 0
0 0
8 0
7 8
0 1
0 0
0 0
8 12
737 378
0 141
13 113
15 0
0 0
150 52
300 31
0 3
79 121
0 0
0 3
0 0
8 59
0 0
0 0
0 0
0 0
0 0
0 0
Pema Permin Stok
Sisa Stok
kaian taan Opname
0 0
0 0
0 10
114 907
10 214
0 0
17 691
 113 841
0 969
0 0
6 175
0 0
0 0
0 0
0 0

0 0
0 7
0 38
59 59
12 21
0 33

rahkan Obat Yang meminta

bat Puskesmas Petugas Sub Unit

.
08 199203 2 013 NIP.
 LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

APRIL 2014

Peneri Perse Pema

NO Nama Obat Stok Awal
maan diaan kaian
1 Abbocath No. 22 31 60 91 69
2 Abbocath No. 24 18 0 18 9
3 Acyclovir Cream 4 0 4 0
4 Acyclovir Tab 36 0 36 0
5 Alopurinol Tab 100 Mg 53 0 53 0
6 Ambroksol 30 Mg 4 0 4 0
7 Ambroxol Sirup 0 0 0 0
8 Aminofilin 200 Mg 69 0 69 11
9 Aminofilin Inj 24mg/Ml 29 0 29 5
10 Amoksisilin 500 Mg 425 200 625 441
11 Amoksisilin Syr. 125 Mg/5ml 4 5 9 4
12 Ampisilin Inj 0 0 0 0
13 Antalgin Tab 500 Mg 137 0 137 73
14 Antasida Doen Tab Kombinasi 187 300 487 279
15 Antasida Syr 20 10 30 24
16 Asam Mefenamat 500 Mg 910 0 910 133
17 Asam Traneksamat Tablet 34 0 34 8
18 Betametason Salep Kulit 5 0 5 0
19 Bioneuron Inj 0 0 0 0
20 Bioplacenton 0 0 0 0
21 Bromhexin Tab 85 0 85 0
22 Caviplex Syrup 7 0 7 0
23 Cefadroksil 500 Mg 141 0 141 34
24 Ciprofloksasin 500 Mg 13 200 213 42
25 Dasabion 0 0 0 0
26 Deksametason Inj 5 Mg/Ml-1 Ml 35 20 55 12
27 Deksametason Tab 0,5 Mg 79 300 379 175
28 Dekstrometorfan Syr 10mg/5ml 8 0 8 0
29 Dekstrometorfan Tab 15 Mg 186 0 186 86
30 Diazepam Inj 5mg/Ml - 2 Ml 0 30 30 0
31 Diazepam Tab 2 Mg 25 0 25 11
32 Difenhidramin Hcl Inj 10mg/Ml-1ml 27 0 27 0
33 Digoksin Tab 0,25 Mg 7 20 27 0
34 Domperidon Syr 0 0 0 0
35 Domperidon/Vometa 0 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 2 0 2 0
38 Eritromisin 250 Mg 0 0 0 0
39 Eritromisin 500 Mg 0 0 0 0
40 Etanol 70% 1 0 1 0
41 Ethyl Klorida (Kloretil) 0 0 0 0
42 Famotidin 20 Mg 1 300 301 158
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30 0
44 Fenobarbital Tab 30 Mg 197 0 197 4
45 Ferrolat 0 0 0 0
46 Fitodiar 0 0 0 0
47 Furosemid Tab 40 Mg 44 50 94 40
48 Gentamicin Inj 0 0 0 0
49 Gentamicin Salep Kulit 1 3 4 1
50 Gentian Violet Larutan 1% 4 0 4 1
51 Glibenklamid Tab 5 Mg 91 0 91 12
52 Gliseril Guaiakolat Tab 100 Mg 3 400 403 212
53 Glukosa Larutan Infus 5% 46 200 246 123
54 Grisiovulvin 0 0 0 0
55 Haemorogard 0 0 0 0
56 Hemorogard / Nuwasir 36 0 36 0
57 Hepagard 0 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 15 0 15 4
59 Hidrokortison Krim 2,5% 1 0 1 0
60 Hyoscine Butylbromide 41 100 141 49
Peneri Perse Pema
NO Nama Obat Stok Awal
maan diaan kaian
61 Ibuprofen Tab 200 Mg 36 0 36 0
62 Infus Set Anak 24 0 24 7
63 Infus Set Dewasa 22 50 72 64
64 Isosorbid Dinitrat Tab Sublingual 58 0 58 0
65 Jarum 0 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 14 0 0 0 0
67 Kalsium Laktas Tab 500 Mg 62 0 62 0
68 Kaptopril 12,5 Mg 212 200 412 351
69 Kaptopril 25 Mg 0 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3cm 0 0 0 0
72 Keji Beling 90 0 90 0
73 Klonidin 100 0 100 32
74 Kloramfenikol Inj 42 80 122 66
75 Kloramfenikol Kapsul 250 Mg 963 0 963 492
76 Kloramfenikol Salep Mata 1% 0 0 0 0
77 Kloramfenikol Syr 24 0 24 3
78 Kloramfenikol Tetes Mata 0,5% 0 0 0 0
79 Kloramfenikol Tetes Telinga 1% 4 0 4 0
80 Klorfeniramin Maleat Tab 4 Mg 2 200 202 143
81 Kotrimoksazol Suspensi 240 Mg/5 Ml 20 0 20 4
 82 Kotrimoksazol Tab 480 Mg 97 200 297 220
83 Laxamex 18 0 18 0
84 Levertran 0 0 0 0
85 Librozim 30 Mg (Enzimfort) 12 0 12 12
86 Lidokain Inj 85 0 85 7
87 Loperamid 68 0 68 31
88 Loratadin 26 50 76 7
89 Magasida Tablet Kunyah 0 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 5 180 185 124
91 Metformin 500 Mg 23 50 73 8
92 Metoklopramid 10 Mg 43 150 193 104
93 Metoklopramid Inj 15 10 25 16
94 Metronidazol Tab 250 Mg 134 0 134 51
95 Metronidazol Tab 500 Mg 0 0 0 0
96 Mikonazol Salep 5 0 5 1
97 Natrium Diklofenak 50 Mg 90 0 90 18
98 Neo Diaform 0 0 0 0
99 Neurobion 5000 Inj 25 110 135 15
100 Neurodex 0 0 0 0
101 Nicholin Inj 0 0 0 0
102 Nifedipin 10 Mg 92 100 192 102
103 Obat Batuk Hitam (Obh) Cairan 8 8 16 5
104 Oksitetrasiklin Hcl Salep Kulit 3% 1 0 1 0
105 Oksitetrasiklin Hcl Salep Mata 1% 0 0 0 0
106 Papaverin Tab 40 Mg 0 0 0 0
107 Parasetamol Syr 12 0 12 6
108 Parasetamol Tab 500 Mg 378 1000 1378 789
109 Piracetam 400 Mg 141 0 141 24
110 Piroksikam 10 Mg 113 0 113 37
111 Prednison 5 Mg 0 0 0 0
112 Prolipid 0 0 0 0
113 Ranitidin Injeksi 52 150 202 141
114 Ringer Laktat 31 300 331 256
115 Salbutamol Larutan Respirator Untuk Neb 3 0 3 0
116 Salbutamol Tablet 2 Mg 121 0 121 108
117 Salbutamol Tablet 4 Mg 0 0 0 0
118 Salisil Bedak 2% 3 0 3 0
119 Simetidin 0 0 0 0
120 Simvastatin 59 0 59 0
121 Sistabon Inj 0 0 0 0
122 Spasmal 0 0 0 0
123 Sulfasetamid Na. Tetes Mata 15% 0 0 0 0
124 Tensigard 0 0 0 0
125 Tramadol 50 Mg 0 0 0 0
126 Tramadol Inj 0 0 0 0
NO Nama Obat Stok AwalPeneri maan
Perse diaanPema kaian
127 Transamin Inj 0 0 0 0
128 Ulcumet 0 0 0 0
129 Urispas 10 0 10 0
130 Vit. B Kompleks 907 0 907 197
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 214 0 214 108
132 Vit. B12 Inj 0 0 0 0
133 Vit. B12 Tablet 50 Mg 691 0 691 54
134 Vit. B6 (Piridoksin Hcl) Tab 10 Mg 841 0 841 98
135 Vit. C (Asam Askorbat) Tab 50 Mg 969 0 969 0
136 Vit. K1 (Fitomenadion) Inj 10 Mg/Ml-1ml 0 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 Mg 175 0 175 0
138 Xanvit Sirup 0 0 0 0
139 Xylomidon 0 0 0 0
140 Zink Dispersibel 0 0 0 0
141 Zyparon Kapl 0 0 0 0
142
143 Dulcolax 0 0 0 0
144 Kaotin sy 7 0 7 1
145 Imulan 38 0 38 0
146 Dimenhidrinate 59 100 159 111
147 Cefixim 21 0 21 0
148 Omeprazol 33 0 33 0

Mengetahui Yang menyerahkan Obat

Kepala Puskesmas kerjo Pengelola Obat Puskesmas

dr.Katarina Iswati Hartini

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013
(LPLPO)

Permin Stok
Sisa Stok
taan Opname
22
9
4
36
53
4
0
58
24
184
5
0
64
208
6
777
26
5
0
0
85
7
107
171
0
43
204
8
100
30
14
27
27
0
0
0
2
0
 0
1
0
143
30
193
0
0
54
0
3
3
79
191
123
0
0
36
0
11
1
92
Permin Stok
Sisa Stok
taan Opname
36
17
8
58
0
0
62
61
0
0
0
90
68
56
471
0
21
0
4
59
16
 77
18
0
0
78
37
69
0
61
65
89
9
83
0
4
72
0
120
0
0
90
11
1
0
0
6
589
117
76
0
0
61
75
3
13
0
3
0
59
0
0
0
0
0
0
Sisa Stok Permin taan
Stok Opname
0
0
10
710
106
0
637
743
969
0
175
0
0
0
0

0
6
38
48
21
33

Yang meminta
Petugas Sub Unit

.
NIP.
LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

MEI 2014

Peneri Perse Pema

NO Nama Obat Stok Awal
maan diaan kaian
1 Abbocath No. 22 22 88 110 81
2 Abbocath No. 24 9 20 29 4
3 Acyclovir Cream 4 0 4 1
4 Acyclovir Tab 36 0 36 16
5 Alopurinol Tab 100 Mg 53 0 53 0
6 Ambroksol 30 Mg 4 0 4 0
7 Ambroxol Sirup 0 0 0 0
8 Aminofilin 200 Mg 58 200 258 0
9 Aminofilin Inj 24mg/Ml 24 0 24 2
10 Amoksisilin 500 Mg 184 600 784 229
11 Amoksisilin Syr. 125 Mg/5ml 5 10 15 0
12 Ampisilin Inj 0 50 50 6
13 Antalgin Tab 500 Mg 64 100 164 66
14 Antasida Doen Tab Kombinasi 208 400 608 251
15 Antasida Syr 6 10 16 14
16 Asam Mefenamat 500 Mg 777 0 777 147
17 Asam Traneksamat Tablet 26 0 26 12
18 Betametason Salep Kulit 5 0 5 0
19 Bioneuron Inj 0 0 0 0
20 Bioplacenton 0 0 0 0
21 Bromhexin Tab 85 0 85 0
22 Caviplex Syrup 7 0 7 3
23 Cefadroksil 500 Mg 107 0 107 78
24 Ciprofloksasin 500 Mg 171 0 171 46
25 Dasabion 0 0 0 0
26 Deksametason Inj 5 Mg/Ml-1 Ml 43 0 43 12
27 Deksametason Tab 0,5 Mg 204 0 204 156
28 Dekstrometorfan Syr 10mg/5ml 8 0 8 1
29 Dekstrometorfan Tab 15 Mg 100 0 100 30
30 Diazepam Inj 5mg/Ml - 2 Ml 30 0 30 0
31 Diazepam Tab 2 Mg 14 25 39 8
32 Difenhidramin Hcl Inj 10mg/Ml-1ml 27 0 27 0
33 Digoksin Tab 0,25 Mg 27 0 27 0
34 Domperidon Syr 0 0 0 0
35 Domperidon/Vometa 0 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 2 0 2 0
38 Eritromisin 250 Mg 0 0 0 0
39 Eritromisin 500 Mg 0 0 0 0
40 Etanol 70% 1 0 1 0
41 Ethyl Klorida (Kloretil) 0 0 0 0
42 Famotidin 20 Mg 143 200 343 303
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30 0
44 Fenobarbital Tab 30 Mg 193 0 193 0
45 Ferrolat 0 0 0 0
46 Fitodiar 0 0 0 0
47 Furosemid Tab 40 Mg 54 0 54 19
48 Gentamicin Inj 0 0 0 0
49 Gentamicin Salep Kulit 3 0 3 1
50 Gentian Violet Larutan 1% 3 0 3 0
51 Glibenklamid Tab 5 Mg 79 0 79 3
52 Gliseril Guaiakolat Tab 100 Mg 191 0 191 188
53 Glukosa Larutan Infus 5% 123 100 223 113
54 Grisiovulvin 0 0 0 0
55 Haemorogard 0 0 0 0
56 Hemorogard / Nuwasir 36 0 36 0
57 Hepagard 0 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 11 0 11 4
59 Hidrokortison Krim 2,5% 1 0 1 0
60 Hyoscine Butylbromide 92 50 142 90
Peneri Perse Pema
NO Nama Obat Stok Awal
maan diaan kaian
61 Ibuprofen Tab 200 Mg 36 0 36 0
62 Infus Set Anak 17 25 42 3
63 Infus Set Dewasa 8 99 107 75
64 Isosorbid Dinitrat Tab Sublingual 58 0 58 0
65 Jarum 0 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 14 0 0 0 0
67 Kalsium Laktas Tab 500 Mg 62 0 62 0
68 Kaptopril 12,5 Mg 61 300 361 229
69 Kaptopril 25 Mg 0 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3cm 0 0 0 0
72 Keji Beling 90 0 90 20
73 Klonidin 68 0 68 18
74 Kloramfenikol Inj 56 30 86 50
75 Kloramfenikol Kapsul 250 Mg 471 120 591 444
76 Kloramfenikol Salep Mata 1% 0 0 0 0
77 Kloramfenikol Syr 21 0 21 1
78 Kloramfenikol Tetes Mata 0,5% 0 0 0 0
79 Kloramfenikol Tetes Telinga 1% 4 0 4 0
80 Klorfeniramin Maleat Tab 4 Mg 59 100 159 123
81 Kotrimoksazol Suspensi 240 Mg/5 16 0 16 2
 82 Kotrimoksazol Tab 480 Mg 77 300 377 272
83 Laxamex 18 0 18 0
84 Levertran 0 0 0 0
85 Librozim 30 Mg (Enzimfort) 0 0 0 0
86 Lidokain Inj 78 0 78 4
87 Loperamid 37 100 137 69
88 Loratadin 69 0 69 8
89 Magasida Tablet Kunyah 0 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 61 90 151 118
91 Metformin 500 Mg 65 0 65 0
92 Metoklopramid 10 Mg 89 100 189 139
93 Metoklopramid Inj 9 10 19 13
94 Metronidazol Tab 250 Mg 83 100 183 24
95 Metronidazol Tab 500 Mg 0 0 0 0
96 Mikonazol Salep 4 0 4 0
97 Natrium Diklofenak 50 Mg 72 0 72 0
98 Neo Diaform 0 50 50 0
99 Neurobion 5000 Inj 120 0 120 16
100 Neurodex 0 0 0 0
101 Nicholin Inj 0 0 0 0
102 Nifedipin 10 Mg 90 0 90 12
103 Obat Batuk Hitam (Obh) Cairan 11 0 11 4
104 Oksitetrasiklin Hcl Salep Kulit 3% 1 0 1 0
105 Oksitetrasiklin Hcl Salep Mata 1% 0 0 0 0
106 Papaverin Tab 40 Mg 0 0 0 0
107 Parasetamol Syr 6 0 6 2
108 Parasetamol Tab 500 Mg 589 500 1089 795
109 Piracetam 400 Mg 117 0 117 0
110 Piroksikam 10 Mg 76 0 76 17
111 Prednison 5 Mg 0 0 0 0
112 Prolipid 0 0 0 0
113 Ranitidin Injeksi 61 100 161 147
114 Ringer Laktat 75 200 275 233
115 Salbutamol Larutan Respirator Untu 3 0 3 0
116 Salbutamol Tablet 2 Mg 13 100 113 67
117 Salbutamol Tablet 4 Mg 0 0 0 0
118 Salisil Bedak 2% 3 0 3 1
119 Simetidin 0 0 0 0
120 Simvastatin 59 0 59 0
121 Sistabon Inj 0 0 0 0
122 Spasmal 0 0 0 0
123 Sulfasetamid Na. Tetes Mata 15% 0 0 0 0
124 Tensigard 0 0 0 0
125 Tramadol 50 Mg 0 0 0 0
126 Tramadol Inj 0 0 0 0
NO Nama Obat Stok AwalPeneri maan
Perse diaanPema kaian
127 Transamin Inj 0 0 0 0
128 Ulcumet 0 0 0 0
129 Urispas 10 0 10 10
130 Vit. B Kompleks 710 0 710 160
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 106 0 106 33
132 Vit. B12 Inj 0 0 0 0
133 Vit. B12 Tablet 50 Mg 637 0 637 11
134 Vit. B6 (Piridoksin Hcl) Tab 10 Mg 743 0 743 59
135 Vit. C (Asam Askorbat) Tab 50 Mg 969 0 969 0
136 Vit. K1 (Fitomenadion) Inj 10 Mg/M 0 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 Mg 175 0 175 0
138 Xanvit Sirup 0 0 0 0
139 Xylomidon 0 0 0 0
140 Zink Dispersibel 0 0 0 0
141 Zyparon Kapl 0 0 0 0
142
143 Dulcolax 0 0 0 0
144 Kaotin sy 6 0 6 0
145 Imulan 38 0 38 0
146 Dimenhidrinate 48 100 148 97
147 Cefixim 21 0 21 0
148 Omeprazol 33 0 33 3

Mengetahui Yang menyerahkan Obat

Kepala Puskesmas kerjo Pengelola Obat Puskesmas

dr.Katarina Iswati Didik Very Ariyanto,Sto,S.Farm.,Apt

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013

Yang meminta
Petugas Sub Unit

Ary Muslikhah
NIP.197804272006042010
 Permin Stok
Sisa Stok
taan Opname
29
25
3
20
53
4
0
258
22
555
15
50
98
357
2
630
14
5
0
0
85
4
29
125
0
31
48
7
70
30
31
27
27
0
0
0
2
0
 0
1
0
40
30
193
0
0
35
0
2
3
76
3
110
0
0
36
0
7
1
52
Permin Stok
Sisa Stok
taan Opname
36
39
32
58
0
0
62
132
0
0
0
70
50
36
147
0
20
0
4
36
14
105
18
0
0
74
68
61
0
33
65
50
6
159
0
4
72
50
104
0
0
90
7
1
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0
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294
117
59
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0
14
42
3
46
0
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59
0
0
0
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Sisa Stok Permin taan
Stok Opname
0
0
0
550
73
0
626
684
969
0
175
0
0
0
0

0
6
38
51
21
30

Mengetahui
Penangung Jawab Rawat Inap

dr.Siswo Haryono
NIP. 197108102006041006
LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

JUNI 2014

NO Nama Obat Stok Awal Peneri maaPerse diaa Pema kaian

1 Abbocath No. 22 29 70 99 61
2 Abbocath No. 24 25 0 25 7
3 Acyclovir Cream 3 0 3 0
4 Acyclovir Tab 20 0 20 0
5 Alopurinol Tab 100 Mg 53 0 53 3
6 Ambroksol 30 Mg 4 0 4 0
7 Ambroxol Sirup 0 0 0 0
8 Aminofilin 200 Mg 258 0 258 4
9 Aminofilin Inj 24mg/Ml 22 0 22 3
10 Amoksisilin 500 Mg 555 0 555 261
11 Amoksisilin Syr. 125 Mg/5ml 15 0 15 6
12 Ampisilin Inj 44 0 44 44
13 Antalgin Tab 500 Mg 98 0 98 55
14 Antasida Doen Tab Kombinasi 357 300 657 387
15 Antasida Syr 2 15 17 15
16 Asam Mefenamat 500 Mg 630 0 630 116
17 Asam Traneksamat Tablet 14 50 64 26
18 Betametason Salep Kulit 5 0 5 0
19 Bioneuron Inj 0 0 0 0
20 Bioplacenton 0 0 0 0
21 Bromhexin Tab 85 0 85 0
22 Caviplex Syrup 4 0 4 3
23 Cefadroksil 500 Mg 29 0 29 26
24 Ciprofloksasin 500 Mg 125 0 125 122
25 Dasabion 0 0 0 0
26 Deksametason Inj 5 Mg/Ml-1 Ml 31 25 56 30
27 Deksametason Tab 0,5 Mg 48 200 248 248
28 Dekstrometorfan Syr 10mg/5ml 7 0 7 0
29 Dekstrometorfan Tab 15 Mg 70 0 70 40
30 Diazepam Inj 5mg/Ml - 2 Ml 30 0 30 0
31 Diazepam Tab 2 Mg 31 0 31 17
32 Difenhidramin Hcl Inj 10mg/Ml 27 0 27 0
33 Digoksin Tab 0,25 Mg 27 0 27 0
34 Domperidon Syr 0 5 5 1
35 Domperidon/Vometa 0 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 2 0 2 0
38 Eritromisin 250 Mg 0 0 0 0
39 Eritromisin 500 Mg 0 0 0 0
 40 Etanol 70% 1 0 1 0
41 Ethyl Klorida (Kloretil) 0 0 0 0
42 Famotidin 20 Mg 40 300 340 269
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30 0
44 Fenobarbital Tab 30 Mg 193 0 193 0
45 Ferrolat 0 60 60 0
46 Fitodiar 0 0 0 0
47 Furosemid Tab 40 Mg 35 0 35 16
48 Gentamicin Inj 0 0 0 0
49 Gentamicin Salep Kulit 2 0 2 2
50 Gentian Violet Larutan 1% 3 0 3 1
51 Glibenklamid Tab 5 Mg 76 0 76 7
52 Gliseril Guaiakolat Tab 100 Mg 3 300 303 141
53 Glukosa Larutan Infus 5% 110 100 210 108
54 Grisiovulvin 0 0 0 0
55 Haemorogard 0 0 0 0
56 Hemorogard / Nuwasir 36 0 36 12
57 Hepagard 0 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 7 50 57 6
59 Hidrokortison Krim 2,5% 1 0 1 0
60 Hyoscine Butylbromide 52 100 152 49
NO Nama Obat Stok Awal Peneri maaPerse diaa Pema kaian
61 Ibuprofen Tab 200 Mg 36 0 36 0
62 Infus Set Anak 39 0 39 7
63 Infus Set Dewasa 32 75 107 59
64 Isosorbid Dinitrat Tab Sublingua 58 0 58 9
65 Jarum 0 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 1 0 0 0 0
67 Kalsium Laktas Tab 500 Mg 62 0 62 0
68 Kaptopril 12,5 Mg 132 200 332 242
69 Kaptopril 25 Mg 0 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3 0 0 0 0
72 Keji Beling 70 0 70 0
73 Klonidin 50 0 50 0
74 Kloramfenikol Inj 36 50 86 70
75 Kloramfenikol Kapsul 250 Mg 147 480 627 402
76 Kloramfenikol Salep Mata 1% 0 0 0 0
77 Kloramfenikol Syr 20 0 20 2
78 Kloramfenikol Tetes Mata 0,5% 0 0 0 0
79 Kloramfenikol Tetes Telinga 1% 4 0 4 0
80 Klorfeniramin Maleat Tab 4 Mg 36 100 136 136
81 Kotrimoksazol Suspensi 240 Mg 14 0 14 3
82 Kotrimoksazol Tab 480 Mg 105 200 305 230
83 Laxamex 18 0 18 2
 84 Levertran 0 0 0 0
85 Librozim 30 Mg (Enzimfort) 0 0 0 0
86 Lidokain Inj 74 0 74 7
87 Loperamid 68 50 118 39
88 Loratadin 61 0 61 23
89 Magasida Tablet Kunyah 0 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 33 120 153 115
91 Metformin 500 Mg 65 0 65 4
92 Metoklopramid 10 Mg 50 200 250 123
93 Metoklopramid Inj 6 30 36 34
94 Metronidazol Tab 250 Mg 159 0 159 112
95 Metronidazol Tab 500 Mg 0 0 0 0
96 Mikonazol Salep 4 0 4 0
97 Natrium Diklofenak 50 Mg 72 0 72 3
98 Neo Diaform 50 0 50 0
99 Neurobion 5000 Inj 104 0 104 18
100 Neurodex 0 0 0 0
101 Nicholin Inj 0 0 0 0
102 Nifedipin 10 Mg 90 0 90 28
103 Obat Batuk Hitam (Obh) Cairan 7 8 15 6
104 Oksitetrasiklin Hcl Salep Kulit 1 0 1 0
105 Oksitetrasiklin Hcl Salep Mata 0 0 0 0
106 Papaverin Tab 40 Mg 0 0 0 0
107 Parasetamol Syr 4 5 9 6
108 Parasetamol Tab 500 Mg 294 1000 1294 855
109 Piracetam 400 Mg 117 0 117 18
110 Piroksikam 10 Mg 59 0 59 40
111 Prednison 5 Mg 0 100 100 21
112 Prolipid 0 0 0 0
113 Ranitidin Injeksi 14 200 214 176
114 Ringer Laktat 42 203 245 243
115 Salbutamol Larutan Respirator 3 0 3 0
116 Salbutamol Tablet 2 Mg 46 50 96 58
117 Salbutamol Tablet 4 Mg 0 0 0 0
118 Salisil Bedak 2% 2 0 2 0
119 Simetidin 0 0 0 0
120 Simvastatin 59 0 59 0
121 Sistabon Inj 0 0 0 0
122 Spasmal 0 0 0 0
123 Sulfasetamid Na. Tetes Mata 1 0 2 2 2
124 Tensigard 0 0 0 0
125 Tramadol 50 Mg 0 0 0 0
126 Tramadol Inj 0 0 0 0
NO Nama Obat Stok Awal Peneri maaPerse diaa Pema kaian
127 Transamin Inj 0 0 0 0
128 Ulcumet 0 0 0 0
129 Urispas 0 0 0 0
130 Vit. B Kompleks 550 0 550 151
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 73 0 73 62
132 Vit. B12 Inj 0 0 0 0
133 Vit. B12 Tablet 50 Mg 626 0 626 38
134 Vit. B6 (Piridoksin Hcl) Tab 10 684 0 684 193
135 Vit. C (Asam Askorbat) Tab 50 969 0 969 0
136 Vit. K1 (Fitomenadion) Inj 10 M 0 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 175 0 175 0
138 Xanvit Sirup 0 0 0 0
139 Xylomidon 0 0 0 0
140 Zink Dispersibel 0 0 0 0
141 Zyparon Kapl 0 0 0 0
142
143 Dulcolax 0 0 0 0
144 Kaotin sy 6 0 6 0
145 Imulan 38 0 38 0
146 Dimenhidrinate 51 0 51 44
147 Cefixim 21 0 21 0
148 Omeprazol 30 0 30 0

Mengetahui Yang menyerahkan Obat

Kepala Puskesmas kerjo Pengelola Obat Puskesmas

dr.Katarina Iswati Didik Very Ariyanto,S.far to,S.Farm.,Apt

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013

Yang meminta
Petugas Sub Unit

Ary Muslikhah
NIP.197804272006042010
Sisa Stok Permin taaStok Opname
38
18
3
20
50
4
0
254
19
294
9
0
43
270
2
514
38
5
0
0
85
1
3
3
0
26
0
7
30
30
14
27
27
4
0
0
2
0
0
 1
0
71
30
193
60
0
19
0
0
2
69
162
102
0
0
24
0
51
1
103
Sisa Stok Permin taaStok Opname
36
32
48
49
0
0
62
90
0
0
0
70
50
16
225
0
18
0
4
0
11
75
16
 0
0
67
79
38
0
38
61
127
2
47
0
4
69
50
86
0
0
90
9
1
0
0
3
439
99
19
79
0
38
2
3
38
0
2
0
59
0
0
0
0
0
0
Sisa Stok Permin taaStok Opname
0
 0
0
399
11
0
588
491
969
0
175
0
0
0
0

0
6
38
7
21
30

Mengetahui
Penangung Jawab Rawat Inap

dr.Siswo Haryono
NIP. 197108102006041006
LEMBAR PENERIMAAN DAN PERMINTAAN OBAT (LPLPO)

JUlI 2014

NO Nama Obat Stok Awal Peneri maaPerse diaa Pema kaian

1 Abbocath No. 22 38 55 93 58
2 Abbocath No. 24 18 0 18 5
3 Acyclovir Cream 3 0 3 0
4 Acyclovir Tab 20 0 20 0
5 Alopurinol Tab 100 Mg 50 0 50 0
6 Ambroksol 30 Mg 4 0 4 0
7 Ambroxol Sirup 0 0 0 0
8 Aminofilin 200 Mg 254 0 254 0
9 Aminofilin Inj 24mg/Ml 19 0 19 1
10 Amoksisilin 500 Mg 294 200 494 213
11 Amoksisilin Syr. 125 Mg/5ml 9 0 9 4
12 Ampisilin Inj 0 0 0 0
13 Antalgin Tab 500 Mg 43 50 93 32
14 Antasida Doen Tab Kombinasi 270 200 470 208
15 Antasida Syr 2 20 22 20
16 Asam Mefenamat 500 Mg 514 0 514 176
17 Asam Traneksamat Tablet 38 0 38 0
18 Betametason Salep Kulit 5 0 5 0
19 Bioneuron Inj 0 0 0 0
20 Bioplacenton 0 0 0 0
21 Bromhexin Tab 85 0 85 0
22 Caviplex Syrup 1 0 1 1
23 Cefadroksil 500 Mg 3 0 3 6
24 Ciprofloksasin 500 Mg 3 200 203 54
25 Dasabion 0 0 0 0
26 Deksametason Inj 5 Mg/Ml-1 Ml 26 0 26 4
27 Deksametason Tab 0,5 Mg 0 500 500 165
28 Dekstrometorfan Syr 10mg/5ml 7 0 7 0
29 Dekstrometorfan Tab 15 Mg 30 50 80 38
30 Diazepam Inj 5mg/Ml - 2 Ml 30 0 30 0
31 Diazepam Tab 2 Mg 14 20 34 11
32 Difenhidramin Hcl Inj 10mg/Ml 27 0 27 0
33 Digoksin Tab 0,25 Mg 27 0 27 0
34 Domperidon Syr 4 0 4 0
35 Domperidon/Vometa 0 0 0 0
36 Efedrin Hcl Tab 25 Mg 0 0 0 0
37 Epinefrina Hcl/Bitartrat Inj 0,1 2 0 2 0
38 Eritromisin 250 Mg 0 0 0 0
39 Eritromisin 500 Mg 0 0 0 0
 40 Etanol 70% 1 0 1 0
41 Ethyl Klorida (Kloretil) 0 0 0 0
42 Famotidin 20 Mg 71 300 371 227
43 Fenobarbital Inj 50mg/Ml-2 Ml 30 0 30 0
44 Fenobarbital Tab 30 Mg 193 0 193 0
45 Ferrolat 60 0 60 6
46 Fitodiar 0 0 0 0
47 Furosemid Tab 40 Mg 19 20 39 4
48 Gentamicin Inj 0 0 0 0
49 Gentamicin Salep Kulit 0 0 0 0
50 Gentian Violet Larutan 1% 2 0 2 1
51 Glibenklamid Tab 5 Mg 69 0 69 0
52 Gliseril Guaiakolat Tab 100 Mg 162 200 362 91
53 Glukosa Larutan Infus 5% 102 100 202 117
54 Grisiovulvin 0 0 0 0
55 Haemorogard 0 0 0 0
56 Hemorogard / Nuwasir 24 0 24 0
57 Hepagard 0 0 0 0
58 Hidroklortiazid (Hct) Tab 25 Mg 51 0 51 1
59 Hidrokortison Krim 2,5% 1 0 1 0
60 Hyoscine Butylbromide 103 0 103 66
NO Nama Obat Stok Awal Peneri maaPerse diaa Pema kaian
61 Ibuprofen Tab 200 Mg 36 0 36 14
62 Infus Set Anak 32 0 32 3
63 Infus Set Dewasa 48 50 98 53
64 Isosorbid Dinitrat Tab Sublingua 49 0 49 3
65 Jarum 0 0 0 0
66 Jarum Jahit (Bedah) No. 9 S/D 1 0 0 0 0
67 Kalsium Laktas Tab 500 Mg 62 0 62 0
68 Kaptopril 12,5 Mg 90 300 390 73
69 Kaptopril 25 Mg 0 0 0 0
70 Kasa Kompres 40/40 Steril 0 0 0 0
71 Kasa Pembalut Hidrofil 4m X 3 0 0 0 0
72 Keji Beling 70 0 70 0
73 Klonidin 50 0 50 0
74 Kloramfenikol Inj 16 90 106 95
75 Kloramfenikol Kapsul 250 Mg 225 480 705 700
76 Kloramfenikol Salep Mata 1% 0 0 0 0
77 Kloramfenikol Syr 18 0 18 0
78 Kloramfenikol Tetes Mata 0,5% 0 0 0 0
79 Kloramfenikol Tetes Telinga 1% 4 0 4 0
80 Klorfeniramin Maleat Tab 4 Mg 0 100 100 158
81 Kotrimoksazol Suspensi 240 Mg 11 0 11 1
82 Kotrimoksazol Tab 480 Mg 75 300 375 148
83 Laxamex 16 0 16 0
 84 Levertran 0 0 0 0
85 Librozim 30 Mg (Enzimfort) 0 0 0 0
86 Lidokain Inj 67 0 67 7
87 Loperamid 79 0 79 15
88 Loratadin 38 200 238 4
89 Magasida Tablet Kunyah 0 0 0 0
90 Mertigo/Betahistin Maleat 6 Mg 38 120 158 101
91 Metformin 500 Mg 61 0 61 0
92 Metoklopramid 10 Mg 127 200 327 149
93 Metoklopramid Inj 2 40 42 18
94 Metronidazol Tab 250 Mg 47 200 247 64
95 Metronidazol Tab 500 Mg 0 0 0 0
96 Mikonazol Salep 4 0 4 0
97 Natrium Diklofenak 50 Mg 69 0 69 14
98 Neo Diaform 50 0 50 1
99 Neurobion 5000 Inj 86 0 86 27
100 Neurodex 0 0 0 0
101 Nicholin Inj 0 0 0 0
102 Nifedipin 10 Mg 90 0 90 54
103 Obat Batuk Hitam (Obh) Cairan 9 0 9 0
104 Oksitetrasiklin Hcl Salep Kulit 1 0 1 0
105 Oksitetrasiklin Hcl Salep Mata 0 0 0 0
106 Papaverin Tab 40 Mg 0 0 0 0
107 Parasetamol Syr 3 10 13 0
108 Parasetamol Tab 500 Mg 439 600 1039 678
109 Piracetam 400 Mg 99 0 99 20
110 Piroksikam 10 Mg 19 0 19 14
111 Prednison 5 Mg 79 0 79 19
112 Prolipid 0 0 0 0
113 Ranitidin Injeksi 38 200 238 157
114 Ringer Laktat 2 260 262 196
115 Salbutamol Larutan Respirator 3 0 3 0
116 Salbutamol Tablet 2 Mg 38 50 88 40
117 Salbutamol Tablet 4 Mg 0 0 0 0
118 Salisil Bedak 2% 2 0 2 0
119 Simetidin 0 0 0 0
120 Simvastatin 59 0 59 0
121 Sistabon Inj 0 0 0 0
122 Spasmal 0 0 0 0
123 Sulfasetamid Na. Tetes Mata 1 0 0 0 0
124 Tensigard 0 0 0 0
125 Tramadol 50 Mg 0 0 0 0
126 Tramadol Inj 0 0 0 0
NO Nama Obat Stok Awal Peneri maaPerse diaa Pema kaian
127 Transamin Inj 0 0 0 0
128 Ulcumet 0 0 0 0
129 Urispas 0 0 0 0
130 Vit. B Kompleks 399 500 899 125
131 Vit. B1 (Tiamin Hcl) Tab 50 Mg 11 200 211 75
132 Vit. B12 Inj 0 0 0 0
133 Vit. B12 Tablet 50 Mg 588 0 588 56
134 Vit. B6 (Piridoksin Hcl) Tab 10 491 0 491 104
135 Vit. C (Asam Askorbat) Tab 50 969 0 969 0
136 Vit. K1 (Fitomenadion) Inj 10 M 0 0 0 0
137 Vit. K1 (Fitomenadion) Tab 10 175 0 175 0
138 Xanvit Sirup 0 0 0 0
139 Xylomidon 0 0 0 0
140 Zink Dispersibel 0 0 0 0
141 Zyparon Kapl 0 0 0 0
142 0
143 Dulcolax 0 0 0 0
144 Kaotin sy 6 0 6 0
145 Imulan 38 0 38 0
146 Dimenhidrinate 7 100 107 22
147 Cefixim 21 0 21 0
148 Omeprazol 30 0 30 0

Mengetahui Yang menyerahkan Obat

Kepala Puskesmas kerjo Pengelola Obat Puskesmas

dr.Katarina Iswati Didik Very Ariyanto,S.far to,S.Farm.,Apt

NIP. 19670428 200003 2 004 NIP. 19680508 199203 2 013

Yang meminta
Petugas Sub Unit

Ary Muslikhah
NIP.197804272006042010
Sisa Stok Permin taaStok Opname
35
13
3
20
50
4
0
254
18
281
5
0
61
262
2
338
38
5
0
0
85
0
-3
149
0
22
335
7
42
30
23
27
27
4
0
0
2
0
0
 1
0
144
30
193
54
0
35
0
0
1
69
271
85
0
0
24
0
50
1
37
Sisa Stok Permin taaStok Opname
22
29
45
46
0
0
62
317
0
0
0
70
50
11
5
0
18
0
4
-58
10
227
16
 0
0
60
64
234
0
57
61
178
24
183
0
4
55
49
59
0
0
90
9
1
0
0
13
361
79
5
60
0
81
66
3
48
0
2
0
59
0
0
0
0
0
0
Sisa Stok Permin taaStok Opname
0
 0
0
774
136
0
532
387
969
0
175
0
0
0
0

0
6
38
85
21
30

Mengetahui
Penangung Jawab Rawat Inap

dr.Siswo Haryono
NIP. 197108102006041006